Eleanor Roosevelt, 1958

'Where, after all, do universal human rights begin? In small places, close to home -- so close and so small that they cannot be seen on any map of the world. Yet they are the world of the individual person... Unless these rights have meaning there, they have little meaning anywhere. Without concerted citizen action to uphold them close to home, we shall look in vain for progress in the larger world.' Eleanor Roosevelt, 1958

The Small Places has moved...

The Small Places has moved to a new home here, including all the old posts. Any posts after 6th March 2014 will appear on the new website, but old posts are preserved here so that URLs linking here continue to work. Please check out the new site.

Thursday 26 September 2013

What do Part 8 Reviews under the DoLS actually do?

The Mental Capacity Act 2005 deprivation of liberty safeguards (DOLS) contain a mechanism whereby a a detention under the DoLS can be reviewed by the supervisory body who has authorised the detention.  What is the point of that mechanism, and how is it working in practice?

I think one of the most common fallacies about Part 8 reviews is that they are some kind of review process which complies with Article 5(4) of the European Convention on Human Rights (ECHR), which says that:
Everyone who is deprived of his liberty by arrest or detention shall be entitled to take proceedings by which the lawfulness of his detention shall be decided speedily by a court and his release ordered if the detention is not lawful.
If we cast our minds back to the case which brought the DoLS into existence, HL v UK  (the 'Bournewood case'), the absence of any (accessible and appropriate) procedure for reviewing the lawfulness of HL's detention was one of the ways in which his human rights had been violated.

Tuesday 17 September 2013

CQC inspections over the last ten years: Back on the up and up...

I've blogged a lot in the past about the all-time-low in inspection of social care services in 2010-11 and the CQC's annus horribilis, so it seemed only fair to blog about the most recent data CQC shared with me about their inspections.  As the CQC's annual report for 2012-13 shows, the number of inspections of services rose from the previous year.  I asked CQC for a more detailed breakdown of the data than was available in that report, so I could see how residential care and home care services fared - as in the past they've been treated quite differently, and I wanted to look at long range patterns.  CQC's FOIA department - one of  the most helpful and speedy I've encountered in my long history of pestering public authorities for information - obliged, and what's even better is that this time the data didn't just say how many inspections they had conducted, but how many services were inspected.  That is a really important statistic, because otherwise reporting that they had conducted, say, 10 inspections and they have 10 services registered makes it appear as if all services were visited - when it could simply be that only two services were visited, but they were so bad they were inspected 5 times.  From CQC's data, it looks as if 95% of residential care services (including care homes and nursing homes) were inspected last year, and 74% of home care services.  Of course, inspection frequency data isn't everything, but it does say something about how far CQC is prioritising 'boots on the ground' which is a necessary (albeit insufficient) precursor to strong regulation.

How do Best Interests Assessors interpret ‘deprivation of liberty’? The Bristol study

Last month the Health and Social Care Information Centre published its latest statistics on the deprivation of liberty safeguards (DoLS). There was something of a dip in the number of applications in the last quarter of 2012 and the first quarter of 2013 (coincidentally, the first two quarters after the ruling in Cheshire West), and a general flattening of the year-on-year rise in applications:

This data release also showed that the extraordinary variability in the number of applications and authorisations under the DoLS between different supervisory bodies has continued into their fourth year*: